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The Firesign Theatre had a comedy album “Everything you know is wrong.”  This axiom turns up again and again throughout my life. Going to medical conferences is no exception. Medicine is an ever-changing field. What was true one year turns out to be not so the next.  Some people see this as a sign of a sham but it is a truism of science.

For example, I was trained in the 80s/90s thems who smoke marijuana were all pot heads and nothing good could come from smoking the stuff.  Yesterday I heard the latest scientific-backed evidence-based data to negate all my training and beliefs.**

I prefer Truth to Dogma, so I try to throw off held-fast beliefs when there is good evidence to support such.  This is not as easy as it sounds as we like steadfast truths. To have the rug constantly pulled out from us leaves us with little firm to stand upon. Most people are uncomfortable without some fixed beliefs.  You might have noticed thems who believe Obama was born in Kenya or deny climate change or think the earth if flat are never swayed by reasoning and evidence; they just dig into their beliefs more.  There are few at ease with moral ambiguities (hey it sings) so they pretend they don’t exist.

As a doctor I can’t ethically do this. Imagine I learn after hundred of years of prescribing bloodletting it turns out to have no value but MDs decide their years of experience with it and ‘it has always been that way’ trumps evidence (pun intended) and they keep prescribing it.   Alas, this happens more often than not. Lots of doctors continue to do things which have little scientific backup.  Deny and discard is more often done than not. I try not to be one of them. I know myself well enough I do and prescribe things

I go back to work on Monday with  new perspectives and an up to date knowledge base – some being 180s to what I used to say and do. Some patients will complain ‘you guys can’t settle on what is right and wrong” but I know I am following the path of science – test a hypothesis and discard it if the evidence doesn’t support it.

 

**There is ‘good’ and ‘truth’ to the possible use of cannabis in the treatment of mental illness yes, but it is not at all what my patients believe.  More on this anon if Spo-fans are interested.

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